CAHFS Weekly Topic: Fighting Panic and Misinformation
Gus Brihn

EDITORIAL: FIGHTING PANIC AND MISINFORMATION

Public Health Response Update


In our last CAHFS Weekly Update, the topic of stigma, misinformation, and fear was briefly discussed. This was brought to light with the recent outrage about where infected or suspected patients should be quarantined and/or isolated in the US. President Trump responded to Alabama senators saying that infected patients from the Diamond Princess cruise ship would not be sent to a facility in Alabama after Alabamians demonstrated significant concern about having the cases treated in their State. Alabama is not the only state to show hesitation surrounding infected people, Costa Mesa, California also appealed when patients were supposed to be sent to a care facility in their town. 

So far what we know is that the outbreak has spread throughout China and 31 other countries, including the United States. A total of 53 cases have been reported in the US. Of those 53 cases, 14 were diagnosed in the US and 39 were diagnosed among repatriated persons from high-risk settings. As of February 23rd, the global total reported cases have reached 78,811 with 76,936 of those reported cases occurring in mainland China. There have been 2,462 associated deaths worldwide; no deaths have been reported in the US.

The CDC has issued several travel notices to inform travelers and clinicians about current health issues that could affect traveler’s health. Level 3 travel notices are in effect for China and South Korea and level 2 travel notices have been posted for Japan, Iran, and Italy. In addition, the CDC has posted information for travelers regarding apparent community transmission in Singapore, Taiwan, Thailand, and Vietnam. In absence of a vaccine or therapeutic for COVID-19, community mitigation measures are the primary method to respond to widespread transmission. These methods, although critical to avert widespread transmission, can be disruptive and have social and economic impacts on individual persons and communities. 

MMWR ​​​

 

Stigma


Some individuals who have been exposed to COVID-19 or some people of Chinese and Asian descent, regardless of whether they have been exposed to COVID-19, are facing stigma in their communities. The CDC identifies stigma as stereotyping and discriminating against an identifiable group of people, a place, or a nation. Regarding COVID-19, it can occur when people associate an infectious disease with a population, even though not everyone in that population or from that region are specifically at risk for the disease (for example, Chinese-Americans living in the United States).

There are many reasons why stigma surrounding COVID-19 occurs including but not limited to: a lack of knowledge about how COVID-19 is spread, a need to blame someone, gossip/rumors/myths/fears/anxiety, and history. Stigma can result in negative comments towards people both directly or indirectly in discussion, via social media, or from the news. It can also lead to people being treated differently, including receiving different healthcare treatments. 

Stigma is harmful to everyone and breeds more fear and anger towards ordinary people instead of the disease that is causing the problem. Obviously, stigma is not limited to infectious diseases although we can see it associated with almost every major disease event including Ebola, HIV, and the flu. Stigma arises anywhere when fear and anxiety go unchecked without appropriate communication. 

CDC: Stigma FAQ
CDC: Stigma and COVID-19

 

Fighting panic


In countries like China, the response has shifted to “wartime control measures,” putting cities on lockdown and affecting an estimated 760 million people. Regional identification, isolation, and treatment implementation has brought a range of high-tech and militarized approaches. There has also been harsh criticism surrounding the silencing of Dr. Li Wenliang, who was arrested after raising concerns about the virus on social media and subsequently died from COVID-19. Other concerns have been about the reported mass round-ups and quarantining of people in unsatisfactory facilities for unspecified durations. 

The global response to COVID-19 has been focused on avoiding a pandemic, which is important, but that can allow for fear and anxiety to grow especially if officials do not appropriately communicate the reasons for their responses. Implementing travel bans to prevent infection spreading, in addition to the debate about whether they are actually effective in halting spread of infectious disease, can also hamper supply chains, leading to stigma and mistrust, and might violate principles of the WHO International Health Regulations. 

Ultimately, as we continue to fight to control this disease, it is important to continually remember that information disseminates rapidly; therefore, the information we put out there must be trustworthy and non speculative. The CDC (links above) provide great resources for professionals and non-professional about COVID-19 related stigma and provide answers to many confusing questions about the disease. 

The Lancet

Gus Brihn

Gus Brihn

Gus completed his undergraduate degree at the U of M in Global Studies, and has spent much of his time abroad, including time in France and Namibia. Gus became interested in emergency medicine from becoming a Wilderness First Responder and NR-EMT. He completed his veterinary degree at the University of Glasgow in Scotland. Gus is interested in zoonotic disease outbreak investigation, prevention, and epidemiology. Outside of work, Gus enjoys rock climbing and doing Brazilian Jiu jitsu. He has an 11 year-old Staffordshire terrier mix breed dog named Sweet Pea.